Laparoscopic management of acute small bowel obstruction.
BACKGROUND
Laparoscopic management of acute small bowel obstruction is hypothetically attractive but little is known of its clinical potential.


METHODS
A retrospective study was undertaken of patients with acute small bowel obstruction requiring surgery, managed by a laparoscopic unit (LU; n = 69) and a general unit (GU; n = 70).


RESULTS
Laparoscopy was performed in 55 patients (80 per cent) in the LU compared with ten (14 per cent) in the GU. Laparoscopic surgery completed treatment in 31 patients (45 per cent) in the LU and assisted in a further 15 (22 per cent). Patients treated laparoscopically were discharged earlier than those treated by laparotomy (median 3 (range 1-15) versus median 8 (range 1-46) days). Patients treated laparoscopically had a higher chance of early unplanned reoperation than those treated by laparotomy (five of 35 versus four of 88) (P < 0.05).


CONCLUSIONS
Laparoscopy can be performed in a high percentage of patients requiring surgery for acute small bowel obstruction. Hospital stay was reduced but the risk of early unplanned reoperation was increased in patients managed laparoscopically.
Bailey
I S
IS
Royal Brisbane Hospital, Australia.
Rhodes
M
M
O'Rourke
N
N
Nathanson
L
L
Fielding
G
G
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome